Why the New CMS Oncology Model is an Inflection Point in Advancing Health Equity
The Centers for Medicare & Medicaid Services, through its Center for Medicare & Medicaid Innovation (CMMI), announced its newest voluntary oncology payment model, Enhancing Oncology Model (EOM). The program starts July 1, 2023, and will serve as a continuation of the Oncology Care Model (OCM) which ended on June 22, 2022. In many ways, the EOM is similar to the OCM – oncology practices take on financial and performance accountability for episodes of care in both models. However, there are some notable differences:
- OCM covered all cancers, while EOM is covering only Medicare patients undergoing chemotherapy for major cancer types (i.e., breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer)
- EOM adds in a focus on health equity, including requirements for electronic patient-reported outcomes (ePROs), screening for patients’ social needs and submission of health equity plans
The addition of health equity requirements aligns with an overall trend of focusing on health equity. The EOM is indicative that health equity is no longer a “nice to have,” but increasingly becoming a requirement – in this case as part of a government program with financial risk. We also saw health equity positioned more prominently in the goals of the Cancer Moonshot to address inequities in access to cancer screening, diagnostics and treatment, as well as in the FDA’s April draft guidance.
Why This Matters:
For the life science industry, the EOM will likely shed light on what manufacturers are doing to reduce disparities, improve equitable access and achieve inclusivity in oncology – and other therapeutic areas.
What life science manufacturers can do:
- Prepare stakeholder communications to account for an increased focus on social disparities, access barriers and calls for increased inclusivity.
- Increase external communications to highlight recent achievements and current initiatives supporting health equity
o To learn more about health equity trends and specific ways life science companies can become a leader in this area, please visit the Syneos Health 2022 Trends Report.